Lymph nodes (or glands) are part of your body’s natural defence system called the lymphatic system. If you’re having surgery for cancer, your doctor may need to remove one or more of your lymph nodes in order to find out if your cancer has spread and to help plan further treatment.
You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
Lymph nodes are small kidney bean-shaped organs located throughout your body, particularly in your armpits, neck and groin. Their main function is to fight infection and filter lymphatic fluid. You may be able to feel swollen nodes in your neck if you have a throat infection or tooth abscess.
Cancer may start in other parts of your body and spread to your lymph nodes. Occasionally, cancers called lymphomas may also start in your lymph nodes.
If you have cancer, for example, breast cancer or melanoma (skin cancer), your surgeon may remove lymph nodes closest to the tumour. This is to find out if the cancer has spread. This will help your doctors to plan the best course of treatment for you.
Depending on the size and location of your cancer, your surgeon may remove the lymph nodes at the same time as removing the primary tumour. For example, in some types of breast cancer, the surgeon removes the lymph nodes in the armpit at the same time as the breast tumour.
Your surgeon may suggest having a sentinel lymph node biopsy. This is a procedure that can help identify the lymph nodes closest to the cancer (the sentinel nodes) and test them to see if they contain cancer cells. If no cancer cells are found in the sentinel nodes, it means it’s less likely that the cancer has spread.
Your surgeon will explain how to prepare for your procedure. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.
Lymph nodes are usually removed under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s advice.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
Your nurse will prepare you for theatre. He or she may ask you to wear compression stockings to help prevent blood clots forming in the veins in your legs.
There are two main surgical methods for removing lymph nodes – open or keyhole surgery.
In open surgery, your surgeon will make a small cut in the affected area and identify the lymph nodes to be removed. He or she will then carefully remove the lymph nodes. Your surgeon will close the cut with dissolvable stitches.
Keyhole surgery is done through small cuts to reach lymph nodes deeper inside your body. Your surgeon will use special instruments to pass through these cuts and look at a monitor to see your lymph nodes. Keyhole surgery isn’t suitable for everybody – your surgeon will advise you if it’s appropriate for you.
Your surgeon will send your lymph nodes to a laboratory to look at the cells to see if these are benign (not cancerous) or cancerous.
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You may have fine tubes running out from your wound. These drain fluid into a bag and are usually removed after a few days. You will have a dressing covering your wound, and will be told when you can remove this.
If your surgeon has used dissolvable stitches, they will not need to be removed but will dissolve completely when the area is healed.
If you have lymph nodes removed from under your armpit or groin area, a physiotherapist will teach you exercises to help you recover. A physiotherapist is a health professional who specialises in maintaining and improving movement and mobility.
You will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours after you get home.
General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you’re in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon’s advice.
Your nurse will give you some advice about caring for your healing wounds before you go home. You will be given a date for a follow-up appointment.
Your results will be ready several days later and will usually be sent in a report to the doctor who requested your procedure. Your doctor will review the results and discuss them with you at your follow-up appointment.
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Remember to do the exercises your physiotherapist showed you to keep the affected area (your arm or leg) mobile. This will reduce the risk of fluid building up in your arm or leg (lymphoedema). It’s also important not to do any strenuous exercise or heavy lifting for several weeks.
As with every procedure, there are some risks associated with having lymph nodes removed. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure – for example, feeling sick as a result of the general anaesthetic. Side-effects of having lymph nodes removed include:
Complications are when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, infection, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).
Specific complications of having lymph nodes removed can include:
You will continue to be at risk of developing lymphoedema for the rest of your life after you have had your lymph nodes removed (see our frequently asked questions for more information about lymphoedema). The following measures can help to reduce your risk.
Produced by Pippa Coulter, Bupa’s Health Information Team, May 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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